We need your help!

This questionnaire enables Howard Putnam to tailor his presentation to meet your needs. Please answer all relevant questions skipping over any which may not apply due to the nature of your program.

Special Request: When returning this form, please enclose any printed material you feel would help Howard better understand your group. This might include annual reports, newsletters, magazines or brochures promoting your event.

Please note: This questionnaire is Howard Putnam's first step in preparing for his presentation at your event. To ensure a program that is tailored to meet your needs it is imperative that it be returned on or before the above-mentioned date.

Thank you! Your help will increase the value of this program.

SpeakersOffice, Inc. 5927 Balfour Court Ste. 103 — Carlsbad, CA 92008 760-603-8110 — Fax: 760-603-8010 E-mail: Cassie@speakersoffice.com

Howard Putnam's Pre-Program Questionnaire

Submit this questionnaire online OR click here for an easy, printable Word Doc version of Howard Putnam's Pre-Program Questionnaire (If your Internet connection tends to "drop-out," we recommend that you print and return the Word Doc version of this questionnaire.)

Your Name
Title
Company
Address
City
State
Zip Code
Phone
Fax
Email
Website
Best time for Howard to reach you:

I. THE PROGRAM

A. What is your program THEME?

What does the theme mean to your group?

B. What kind of meeting is it? (annual meeting, awards banquet, etc.?)

C. Who is responsible for calling this meeting? (HR, Sales, Marketing?)
Name:	Title:
D. What is the name and title of Howard's introducer?
Name:	Title:
E. Exact times of Howard's presentation? (Please attach program agenda)
Starting:	Ending:
F. When is the best time for Howard to do his A/V and Room Check?
Option #1	Option #2
G. How should Howard dress for his presentation?
Suit and tie Slacks and sport shirt (or client provided "theme shirt")

H. What is Howard's role in the program (Opening or Closing Keynote, Luncheon Speaker, etc.)?

I. Who are the other professional speakers on this program?

1. Speaker:

Topic:

Day:

2. Speaker:

Topic:

Day:

J. What professional speakers have you used in the past?
Speaker:	Year:
Speaker:	Year:
Speaker:	Year:

K. What did you specifically like/dislike about their performance? Why?

Like:

Dislike:

L. Would you like information about Howard's learning materials to reinforce the impact of Howard's ideas after his presentation? Yes No

II. LOGISTICAL INFORMATION
A. What is the nearest major airport to the meeting site?
Distance to meeting site?
Miles:	Time:
B. For transportation from the airport to the meeting site would you prefer: To have Howard met at the airport? Where?
To have Howard take a cab? Approximate cost? N/A (Local Meeting) Other

C. Exactly where is the meeting?
Hotel:
Address:
City:
State:
Zip:
Phone #:
FAX#:
*** Confirmation # for the hotel room reservation:

D. Will you be using Image Magnification (IMAG)? Yes No
Will a video crew be on site? Yes No
If so, what is the:
Company Name
Contact Person
Phone Number

E. If Howard has any problems/emergencies on his way to the program, who should he contact? (Please include cell, business & home phone.)
Name:
Cell Phone:
Business Phone:
Home Phone:

F. If there is a scheduled function the evening prior, please let us know time, place, nature and appropriate dress:

III. AUDIENCE ANALYSIS

A. Audience:

1. Number attending?

2. Are spouses invited? Yes No

3. Percentage of males/females:

4. Average age of group?

5. Job Titles:

B. Toward which group should Howard primarily direct his presentation?

C. Who are the people within your organization responsible for the following:
1. President/Exec. Director:
Name
Exact Title
Email Address
2. VP of Sales/Marketing:
Name
Exact Title
Email Address
3. Sales Training Manager:
Name
Exact Title
Email Address
D. What issues keep your CEO awake at night?

IV. GENERAL BACKGROUND INFORMATION

A. What industry does your organization belong to?

Accounting Insurance Association Manufacturing Automotive & Transportation Media & Publishing Building/Construction Oil Service & Supply Computers Pharmaceuticals Consumer Products Real Estate Distribution Retail Engineering Telecommunications Financial Services Travel/Tourism/Hospitality Food Utilities Healthcare Other Human Resource Services Information Systems

B. What three main things should Howard know about your group?

1.

2.

3.

C. Is there any jargon Howard should be familiar with (acronyms, titles?)

D. On which target markets/industries does your organization primarily focus?

E. Who is your typical customer (e.g.: CFO, VP of HR, Purchasing Agent)?

F. What is the primary product/service that you sell?

G. Who are your major competitors?

H. Any additional comments or information that would be helpful in tailoring this presentation for your group? Thank you